=============================================================================
Run Date: DEC 07, 2021                     Designation: PXRM*2*71
Package : PXRM - CLINICAL REMINDERS           Priority: Mandatory
Version : 2        SEQ #61                      Status: Released
                  Compliance Date: JAN 21, 2022
=============================================================================

Associated patches: (c)OR*3*498        install with patch       `PXRM*2*71'
                    (v)WV*1*26         install with patch       `PXRM*2*71'
                    (c)PSO*7*622       install with patch       `PXRM*2*71'
                    (c)TIU*1*341       install with patch       `PXRM*2*71'
                    (v)PXRM*2*42   <<= must be installed BEFORE `PXRM*2*71'
                    (v)PXRM*2*75   <<= must be installed BEFORE `PXRM*2*71'

Subject: CPRS V31.B FOLLOW-ON

Category: 
  - Routine

Description:
============

 This patch is part of the CPRS v31b follow-up updates. Below is a list of 
 all the applications involved in this project along with their patch
 numbers:
    
     APPLICATION/VERSION                                 PATCH
     ---------------------------------------------------------------
     WOMEN'S HEALTH v1.0                                 WV*1.0*26
     CLINICAL REMINDERS v2.0                             PXRM*2.0*71   
     OUTPATIENT PHARMACY v7.0                            PSO*7.0*622 
     TEXT INTEGRATION UTLITIES v1.0                      TIU*1.0*341
     ORDER ENTRY/RESULTS REPORTING v3.0                  OR*3.0*498
  
 All these patches are released via a Kernel Installation and Distribution
 System (KIDS) multi-build distribution as CPRS V31B FOLLOW-UP PATCHES 1.0.
  
 Patch Components:
 -----------------
 Files & Fields Associated:
  
 File Name (Number)          Field Name (Number)       New/Modified/Deleted
 ------------------          -------------------       --------------------
 REMINDER DIALOG (801.41)    
   BRANCHING LOGIC sub file      EVALUATION ITEM (1)            Modified
  (801.41143)
  
  
 Forms Associated:
  
 Form Name                   File Number               New/Modified/Deleted
 ---------                   -----------               --------------------
    n/a
  
 Mail Groups Associated:
  
 Mail Group Name             New/Modified/Deleted
 ---------------             --------------------
    n/a
  
 Options Associated:
  
 Option Name                 Type                      New/Modified/Deleted
 -----------                 ----                      --------------------
    n/a
  
 Protocols Associated:
  
 Protocol Name               New/Modified/Deleted
 -------------               --------------------
    n/a
  
 Security Keys Associated: 
  
 Security Key Name
 -----------------
    n/a
  
 Templates Associated:
  
 Template Name         Type    File Name (Number)      New/Modified/Deleted
 -------------         ----    ------------------      --------------------
 PXRM EDIT GROUP       Input      801.41                  Modified
 PXRM EDIT NATIONAL    Input      801.41                  Modified
   DIALOG
  
 Remote Procedures Associated:
  
 Remote Procedure Name       New/Modified/Deleted
 ---------------------       --------------------
     n/a
  
 Parameter Definitions Associated:
  
 Parameter Name              New/Modified/Deleted
 --------------              --------------------
     n/a
  
 Additional Information:
 -----------------------
  
 New Service Requests (NSRs):
     n/a
  
 Patient Safety Issues (PSIs):
    n/a
  
  
 Defect Tracking System Ticket(s) & Overview:
    n/a
  
 1. <SUBSCRIPT>LINK2TIU+16^PXRMDUTL error JIRA PXRM-341
  
 Problem:
 --------
 End user received a hard error when entering a blank for any prompt in 
 the menu option Link Reminder Dialog to Template. 
 <SUBSCRIPT>LINK2TIU+16^PXRMDUTL 
  
 Resolution:
 -----------
 Updated the prompt to be able to handle a blank for the different 
 questions
  
 2. subscript error in GETRAD ^ PXRMORCH due to duplicate imaging type 
 names error JIRA PXRM-405
  
 Problem:
 --------
 An error occurred when processing an Imaging Orderable Item, but the 
 Imaging Type file has more than one entry with the same name
  
 Resolution:
 -----------
 Update the Reminder Order Checks system to check for multiple Imaging 
 Type entries with the same name.
  
 3. Remove the outside location prompt to speed up the performance of the 
 dialog JIRA PXRM-29
  
 Problem:
 --------
 It was found when using the PXRM OUTSIDE LOCATION prompt, a decrease in 
 performance in the CPRS GUI was noticed.
  
 Resolution:
 -----------
 Replace the PXRM OUTSIDE LOCATION prompt with the PXRM COMMENT prompt.
  
 4. Support resulting Dense versus non-Dense Results JIRA PXRM-28
  
 Problem:
 --------
 It was found that the SMART dialogs need a way to if the patient has 
 Dense or Non-Dense Breast tissue
  
 Resolution:
 -----------
 Update the SMART Dialog branching logic to display a Dense or Non-Dense 
 Breast Tissue group depending on the Radiology Secondary Diagnosis. Also 
 updated the Female Outside version of the SMART dialog to allow the end 
 user to document Dense or Non-Dense Breast Tissue when documenting an 
 outside Radiology Report.
  
 5. Add Breast Tomosynthesis as possible values, imports from Radiology, 
 and update the Cascade JIRA PXRM-27
  
 Problem:
 --------
 It was found that the SMART dialogs need a way to document if a patient 
 has a Breast Tomosynthesis and separate from the Mammogram Screening
  
 Resolution:
 -----------
 Update the SMART Dialog to support Radiology Procedures that were enter 
 into the Radiology package as a Breast Tomosynthesis. Also updated the 
 outside version of the SMART dialog to allow the end user to document a 
 Breast Tomosynthesis when documenting an outside Radiology Report.
  
 6. Restructure SMART dialog to support abnormal Radiology Result being 
 reported as Normal radiology results JIRA PXRM-25
  
 Problem:
 --------
 It was found that the SMART dialogs need to document additional 
 procedures outside the standard recommendations for BIRAD 2 radiology 
 results.
  
 Resolution:
 -----------
 The female version SMART dialogs was updated to allow selecting a type of 
 procedure and the date the procedure should be done.
  
 7. Display the new patient follow-up date in the Cascade WindowJIRA 
 PXRM-26
  
 Problem:
 --------
 With the change in JIRA PXRM-25, it was requested to show the date 
 entered in the SMART dialog when viewing the Cascade after the 
 documentation. 
  
 Resolution:
 -----------
 The cascade software was updated to display the date entered for the 
 Breast Image selected in the Reminder Dialog.
  
 8. Inactive the stand alone SMART outside dialog JIRA PXRM-24
  
 Problem:
 --------
 It was decided by the Women's Health Program Office the stand alone VA-WH 
 SMART OUTSIDE BREAST IMAGE RESULT dialog is no longer needed
  
 Resolution:
 -----------
 This patch will inactivate the VA-WH SMART OUTSIDE BREAST IMAGE RESULT 
 dialog
  
 9. Set the outside version of the SMART dialog to suppress the main 
 checkboxesJIRA PXRM-23
  
 Problem:
 --------
 It was found that the end user could complete the outside version of 
 SMART dialog with selecting a procedure result and/or how the patient was 
 notified of the results.
  
 Resolution:
 -----------
 The document the result group and the patient notification groups were 
 set to suppress the checkbox.
  
 10. Add this is a duplicate report to all possible Dialog Groups in the 
 main SMART dialog. JIRA PXRM-22
  
 Problem:
 --------
 In the current version of the SMART dialogs, a duplicate a report option 
 is available for BIRAD 1 and 2. This option is needed for all possible 
 result procedure.
  
 Resolution:
 -----------
 Add a duplicate report option to all result groups
  
 11. Fix rename TIU Templates to a note title when linking a template to a 
 note title JIRA PXRM-343
  
 Problem:
 --------
 When using the Link Reminder Dialog to Template option and marking the 
 dialog link to a note title. The name of the template created by this 
 option is not set to the note title name.
  
 Resolution:
 -----------
 Change the code to set the template name to the same name as the note 
 title
  
 12. Change Dialog to Note mapping utility for performance issues if site 
 have a big gap in TIU PXRM REMINDER DIALOG parameter sequence numbers 
 JIRA PXRM-21
  
 Problem:
 --------
 Site may receive an error if sequence numbers in TIU PXRM REMINDER DIALOG 
 parameter have extremely big gap
  
 Resolution:
 -----------
 Change the code to switch from an iterate through the numbers to a 
 standard $Order For loop 
  
 13. Updates to Reminder General Findings for incorrect mapping to WH 
 Purpose of Notification JIRA PXRM-342
  
 Problem:
 --------
 The BR BIRAD 1, RETURN TO AGE SCREENING and BR BIRAD 2, RETURN TO AGE 
 SCREENING General Findings Entries were referencing the wrong entries in 
 the WH Purpose of Notification file.
  
 Resolution:
 -----------
 These two General Findings were updated to reference the correct WH 
 Purpose of Notification entries.
  
 14. Updates to Reminder Terms to address wrong condition statement JIRA 
 PXRM-20
  
 Problem:
 --------
 The VA-WH NEXT BREAST PROCEDURE condition statement was referring the 
 Mammogram Screening procedure entries. Also, this term was pulling back 
 Mammogram Screening procedure entries in the past.
  
 Resolution:
 -----------
 Update the Reminder Term condition statement to search for procedure in 
 the Women's Health package that contain the word Mammogram. Also updated 
 the computed finding and the term to return a procedure if it falls 
 within the Beginning/Ending Dates.
  
 15. Fix a problem with the Reminder General Finding not showing at the 
 bottom of note when reviewing the note in a second sessionJIRA PXRM-19
  
 Problem:
 --------
 The Reminder General Findings are not showing at the bottom of the note 
 in CPRS when viewing after the initial data entry. 
  
 Resolution:
 -----------
 Update the Reminder Code to receive the note IEN and the Visit 
 information and to pass that information to Women's Health package for 
 data retrieval.
  
 16. PXRM-406 PREGNANCY STATUS REVIEW Notification Sent to Entering 
 Provider
  
 Problem:
 --------
 Consider a pregnancy laboratory test entered by a user on behalf of the
 ordering provider (for example, a clerk). When that test is resulted, if 
 the PREGNANCY STATUS REVIEW notification is generated, it is sent to the 
 entering user and not the ordering provider.
  
 Resolution:
 -----------
 The code was modified to send the PREGNANCY STATUS REVIEW notification to 
 the ordering provider.
  
 17. PXRM-409 Status Conflict Review Notification Evaluation Date
  
 Problem:
 --------
 When an ICD code or SNOMED code is added to a visit that occurred in the 
 past, the software compares that code with the patient's status as of 
 today, not the date of the visit.
  
 Resolution:
 -----------
 Modified the software to compare the ICD code or SNOMED code with the 
 patient's status on the date of the visit.
  
 18. PXRM-412 Move Medication Dolutegravir to New Reminder Order Check 
 Items Group
  
 Problem:
 --------
 The Pharmacy Benefits Management group (PBM) requested that the following 
 list of medications are removed from the VA-WH HIRISK MEDICATIONS 
 (EXTREME RISK) GROUP reminder order check items group and added to the 
 VA-WH HIRISK MEDICATIONS (MOD/HIGH RISK DURING PREGNANCY) GROUP and VA-WH 
 HIRISK MEDICATIONS (MODERATE/HIGH RISK) GROUP reminder order check items 
 groups:
  
     ABACAVIR/DOLUTEGRAVIR/LAMIVUDINE
     DOLUTEGRAVIR
     DOLUTEGRAVIR/RILPIVIRINE
  
 Resolution:
 -----------
 The post-install will remove the listed medications from the VA-WH HIRISK 
 MEDICATIONS (EXTREME RISK) GROUP reminder order check items group. A new 
 reminder exchange entry was created that when installed by the Clinical 
 Applications Coordinator (CAC) will add the listed medications to the 
 requested groups.
  
 19. PXRM-414 Add 28 WEEKS' GESTATION CSUB to VA-WH PATIENT DOCUMENTATION
     Reminder Computed Finding
  
 Problem:
 --------
 The VA Sierra Pacific Network (VISN 21) has requested that a new CSUB 
 titled TWENTY-EIGHT WEEKS' GESTATION is added to the VA-WH PATIENT
 DOCUMENTATION reminder computed finding. This new CSUB is useful as a
 display item in reminder definitions, such as TDAP.
  
 Resolution:
 -----------
 The software was modified to return the requested CSUB. It is calculated 
 as a date 28 weeks after the last menstrual period. If there is no last 
 menstrual period, the CSUB is not returned.
  
 20. PXRM-415 Add Medications to Various Women's Health High Risk   
     Medications Order Check Items Groups
  
 Problem:
 --------
 The Pharmacy Benefits Management Group (PBM) has requested the following 
 additions to the Women's Health High Risk Medications order check items 
 groups:
  
    VA-WH HIRISK MEDICATIONS (EXTREME RISK) GROUP
    =============================================
    APALUTAMIDE
    CHENODEOXYCHOLIC ACID
    ELAGOLIX
    HALOBETASOL/TAZAROTENE
    LETROZOLE/RIBOCICLIB
  
    VA-WH HIRISK MEDICATIONS (MODERATE/HIGH RISK) GROUP
    ===================================================
    ABACAVIR/DOLUTEGRAVIR/LAMIVUDINE
    ALENDRONATE
    ALENDRONATE/CHOLECALCIFEROL
    AMLODIPINE/PERINDOPRIL
    ARMODAFINIL
    ATAZANAVIR/COBICISTAT
    ATROPINE/HYOSCYAMINE/PHENOBARBITAL/SCOPOLAMINE
    COBICISTAT
    COBICISTAT/DARUNAVIR
    COBICISTAT/DARUNAVIR/EMTRICITABINE/TENOFOVIR
    COBICISTAT/ELVITEGRAVIR/EMTRICITABINE/TENOFOVIR
    DAUNORUBICIN/CYTARABINE
    DOLUTEGRAVIR
    DOLUTEGRAVIR/LAMIVUDINE
    DOLUTEGRAVIR/RILPIVIRINE
    ETIDRONATE
    IBANDRONATE
    METHACHOLINE CHLORIDE
    MILTEFOSINE
    MODAFINIL
    RISEDRONATE
    SELINEXOR
  
    VA-WH HIRISK MEDICATIONS (MOD/HIGH RISK DURING PREGNANCY) GROUP
    ===============================================================
    ABACAVIR/DOLUTEGRAVIR/LAMIVUDINE
    ADAPALENE/BENZOYL PEROXIDE
    ALENDRONATE
    ALENDRONATE/CHOLECALCIFEROL
    AMLODIPINE/CELECOXIB
    AMLODIPINE/PERINDOPRIL
    ARMODAFINIL
    ASPIRIN/OMEPRAZOLE
    ATAZANAVIR/COBICISTAT
    BEMPEDOIC ACID
    BEMPEDOIC ACID/EZETIMIBE
    COBICISTAT
    COBICISTAT/DARUNAVIR
    COBICISTAT/DARUNAVIR/EMTRICITABINE/TENOFOVIR
    COBICISTAT/ELVITEGRAVIR/EMTRICITABINE/TENOFOVIR
    DAUNORUBICIN/CYTARABINE
    DOLUTEGRAVIR
    DOLUTEGRAVIR/LAMIVUDINE
    DOLUTEGRAVIR/RILPIVIRINE
    ETIDRONATE
    IBANDRONATE
    LACTIC ACID/OCTOXYNOL 9/SODIUM LACTATE
    METHACHOLINE CHLORIDE
    MILTEFOSINE
    MODAFINIL
    PRASTERONE
    RISEDRONATE
    SELINEXOR
    SILVER SULFADIAZINE
    TROLAMINE SALICYLATE
    ULIPRISTAL
  
 Resolution:
 -----------
 A new reminder exchange entry was created that when installed by the 
 Clinical Applications Coordinator (CAC) will add the listed medications 
 to the requested groups.
  
 21. PXRM-418 Multiple Women's Health High Risk Medications Dialog Changes
  
 Problem:
 --------
 The Women's Health program office requests the following changes to the 
 Pregnancy/Intentions/Contraception reminder dialog:
  
 * Change the radio buttons for the pregnancy test and emergency 
 contraceptive quick orders to check boxes to enable providers to order 
 both.
 * Reword the option "Pregnancy can't result with current partner or never 
 sexually active with a man (e.g. same sex partner or partner has 
 vasectomy)" to "Patient asexual or pregnancy can't result with current 
 partner (e.g. same sex partner or partner has vasectomy/is sterile)" to 
 make this contraceptive method clearer. The text that is added to the 
 note when this method is selected should state "The patient states that 
 pregnancy cannot result with her current partner or she is asexual."
 * Change the group containing the emergency contraceptive quick order to 
 LOCAL giving sites the option to remove that quick order from the dialog.
 * When processing a status conflict notification and the user selects No 
 when prompted to update the status, he/she should not have to check an 
 additional box to clear the notification.
  
 Resolution:
 -----------
 The requested dialog changes were made.
  
 22. PXRM-430 <UNDEFINED>TERM+22^PXRMRUL1 *INST
  
 Problem:
 --------
 Given a reminder list rule that uses the VA-WH PATIENT DOCUMENTATION 
 reminder computed finding, this rule fails to generate a patient list and 
 instead generates this error.
  
 Resolution:
 -----------
 The code was modified to no longer generate the error in this situation.
  
 23. PXRM-431 <UNDEFINED>EVAL+22^PXRMPLAB *INST
  
 Problem:
 --------
 Members of the reminder management mailgroup report receiving emails like 
 the following:
 Subj: Clinical Reminder Laboratory HL7 listener.  [#19599] 01/27/21@14:34
 16 lines
 From: Clinical Reminders Support  In 'IN' basket.   Page 1  *New*
 --------------------------------------------------------------------------
 An unexpected error was encountered: <UNDEFINED>EVAL+22^PXRMPLAB *INST
  
 Resolution:
 -----------
 A Pharmacy API kills the INST variable upon finishing, which generates 
 this email message. The code was modified to protect this variable and 
 therefore stop generating these email messages.
  
 24. PXRM-675 Update the Contents of the HRMW Reminder Order Items Groups
  
 Problem:
 --------
 The Pharmacy Benefits Management Group (PBM) has requested the following 
 additions to the Women's Health High Risk Medications order check items 
 groups:
  
    VA-WH HIRISK MEDICATIONS (EXTREME RISK) GROUP
    =============================================
    EZETIMIBE/ROSUVASTATIN
    SELINEXOR
    VERICIGUAT
  
    VA-WH HIRISK MEDICATIONS (MOD/HIGH RISK DURING PREGNANCY) GROUP
    ===============================================================
    BUPIVACAINE/MELOXICAM
  
    VA-WH HIRISK MEDICATIONS (LACTATION LEVEL 1) GROUP
    ==================================================
    AMIVANTAMAB-VMJW
    CABOTEGRAVIR
    CABOTEGRAVIR/RILPIVIRINE
    DOSTARLIMAB
    DOSTARLIMAB-GXLY
    LONCASTUXIMAB TESIRINE-LPYL
    PEGCETACOPLAN
    RAVULIZUMAB-CWVZ
    RITUXIMAB-ABBS
    RITUXIMAB-ARRX
    RITUXIMAB-PVVR
    RITUXIMAB/HYALURONIDASE
    SELINEXOR
    TEPOTINIB
    TIVOZANIB
    TOFACITINIB
    TRILACICLIB
    UMBRALISIB
    VERICIGUAT
    VOCLOSPORIN
  
 Resolution:
 -----------
 A new reminder exchange entry was created that when installed by the 
 Clinical Applications Coordinator (CAC) will add the listed medications 
 to the requested groups.
  
 Test Sites:
 -----------
 Northport VAMC (Northport, NY)
 Durham VA Health Care System (Durham, NC)
 Pittsburgh VA Medical Center (Pittsburgh, PA) 
  
 Software and Documentation Retrieval Instructions:
 --------------------------------------------------
 The software for this patch is being released using 
 a host file.
  
 The host file is available at the following location:
 /srv/vista/patches/SOFTWARE/CPRSV31B_FOLLOW_UP.KID
  
 Documentation describing the new functionality is not included in this 
 release.
  
 Documentation Title                             File 
 Name                     
 ---------------------------------------------------------------------
 N/A
  
 Patch Installation:
 -------------------
 Please refer to the "CPRS v31b Follow-Up Build Deployment, Installation,
 Back Out and Rollback Guide" for installation and set-up information. This
 document is exported as OR_3_0_498_DIBR.DOCX and OR_3_0_498_DIBR.PDF.
  
  
 Back-Out/Roll Back Plan:
 ------------------------
 Please refer to the "CPRS v31b Follow-Up Build, Deployment, Installation,
 Back Out and Rollback Guide.

Routine Information:
====================
The second line of each of these routines now looks like:
;;2.0;CLINICAL REMINDERS;**[Patch List]**;Feb 04, 2005;Build 43

The checksums below are new checksums, and
 can be checked with CHECK1^XTSUMBLD.

Routine Name: PXRMCALT
    Before: B77967002   After:B108062944  **45,75,71**
Routine Name: PXRMCOPY
    Before: B40684741   After: B44260657  **6,12,26,45,71**
Routine Name: PXRMCWH
    Before:B171687768   After:B205206809  **1,4,45,71**
Routine Name: PXRMCWH1
    Before: B75101239   After: B76553371  **45,71**
Routine Name: PXRMDGFC
    Before:       n/a   After: B15804854  **71**
Routine Name: PXRMDLED
    Before:  B9035343   After: B10261556  **45,71**
Routine Name: PXRMDLG4
    Before: B97297359   After:B100687855  **4,6,12,16,26,45,71**
Routine Name: PXRMDUTL
    Before: B54785155   After: B57754306  **24,26,53,45,71**
Routine Name: PXRMEXU4
    Before:B129418811   After:B135631400  **6,12,22,26,45,71**
Routine Name: PXRMGEV
    Before: B45035775   After: B45380121  **45,71**
Routine Name: PXRMGEVA
    Before: B68770332   After: B69344885  **45,71**
Routine Name: PXRMNTFY
    Before: B96364741   After:B112290772  **24,45,71**
Routine Name: PXRMORCH
    Before: B97722828   After:B105863585  **16,22,26,47,45,71**
Routine Name: PXRMP71I
    Before:       n/a   After: B77309826  **71**
Routine Name: PXRMPLAB
    Before: B29899188   After: B30988297  **45,71**
Routine Name: PXRMPRAD
    Before: B36221819   After: B42218466  **45,71**
Routine Name: PXRMRPCG
    Before:B131944434   After:B132169684  **45,71**
Routine Name: PXRMRUL1
    Before: B51234217   After: B51780833  **4,6,26,47,45,71**
 
Routine list of preceding patches: 75

=============================================================================
User Information:
Entered By  :                               Date Entered  : JAN 28, 2020
Completed By:                               Date Completed: DEC 07, 2021
Released By :                               Date Released : DEC 07, 2021
=============================================================================


Packman Mail Message:
=====================

No routines included